併用Haloperidol於Olanzapine後出現白血球降低

Decreased White Blood Cell Count Related to Haloperidol Add-on Treatment to Olanzapine

背景：白血球低下是抗精神病藥物嚴重的副作用之一。Clozapine、olanzapine、chlorpromazine 引起之白血球低下較為常見，haloperidol 只有零星的報告。探討用olanzapine 及haloperidol 與血液學副作用相關性的研究尚不多。個案報告：我們報告了一名精神分裂 症個案，其白血球數量在併用olanzapine 與haloperidol 時減少，但在停用haloperidol 後 快速回升。結論：此個案提醒我們注意haloperidol 或併用抗精神病藥物的白血球低下效 應。面對疑似抗精神病藥物造成白血球低下的個案，除了考慮最常提及的幾種藥物之外，觀 察其他抗精神病藥物的影響亦相當重要。

Background: Leukopenia is a potentially severe side effect of antipsychotic drugs. Clozapine, olanzapine, and chlorpromazine are found to induce leukopenia. Haloperidol-induced leukopenia is occasionally reported. Research are limited to explore hematologic side effects related to the combined use of olanzapine and haloperidol. Case Report: We present a case of a patient with schizophrenia, whose white blood cell count was decreased following receiving a combination of haloperidol and olanzapine, and increased rapidly after discontinuing haloperidol. Conclusion: This case reminds us paying attention to the leukopenic effect of the use of haloperidol or combined antipsychotic drugs. Encountering a patient with a suspected antipsychotics-induced hematologic problem, clinicians need to consider those frequently mentioned offending agents, and to observe its relation with other antipsychotic drugs.